Metastatic neuroendocrine carcinomas to the head and neck: report of 4 cases and review of the literature.

Neuroendocrine carcinoma (NEC) is a cancer arising from neuroendocrine cells, most commonly in the lungs. Rarely, NEC may metastasize to the head and neck. Here, we present 4 cases of metastatic NEC to the jaws and major salivary glands. Patients were 3 females and 1 male, ages ranging from 48 to 82 (mean 59). Three primaries were located in the lung and one in the breast. The parotid was the site of metastasis in 2 patients, with the jaws being involved in the other 2. Histologic and immunohistochemical examination revealed 2 well-differentiated NEC and 2 poorly differentiated NEC. Treatment included surgery, radiation, and chemotherapy. Our series shows these lesions can present in the oral and maxillofacial region as frank malignancies or mimic benign processes. Although rare, these tumors should be included in the differential diagnosis of head and neck lesions, particularly when the patient presents with a history of a previous NEC.